Lecture 7 - Climate Change burden of disease.pdf

Certainly! Here's a condensed overview of the climate change burden of disease and essential mitigation measures:

**Introduction to Climate Change and Health**

Climate change, driven primarily by human activities such as burning fossil fuels and deforestation, is altering the Earth's climate system, leading to a range of impacts on human health. These impacts, collectively known as the climate change burden of disease, include both direct and indirect effects on physical and mental health.

**Direct Health Impacts**

1. **Extreme Weather Events**: Climate change intensifies extreme weather events such as hurricanes, heatwaves, floods, and wildfires, leading to injuries, displacement, and fatalities.

2. **Heat-related Illnesses**: Rising temperatures increase the frequency and severity of heatwaves, contributing to heat-related illnesses such as heatstroke, dehydration, and heat exhaustion.

3. **Vector-borne Diseases**: Changes in temperature and precipitation patterns affect the distribution and abundance of disease-carrying vectors like mosquitoes and ticks, increasing the spread of diseases like malaria, dengue fever, and Lyme disease.

4. **Air Quality**: Climate change exacerbates air pollution, leading to respiratory and cardiovascular diseases such as asthma, bronchitis, and heart attacks.

**Indirect Health Impacts**

1. **Food Security**: Climate change disrupts agricultural systems, leading to crop failures, food shortages, malnutrition, and foodborne diseases.

2. **Waterborne Diseases**: Changes in precipitation patterns and water availability impact water quality, increasing the risk of waterborne diseases such as cholera and typhoid fever.

3. **Mental Health**: The stress of experiencing climate-related events, loss of livelihoods, and displacement can exacerbate mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD).

**Vulnerable Populations**

Certain populations are particularly vulnerable to the health impacts of climate change, including:

- **Children**: Due to their developing physiology and dependency on caregivers.
- **Elderly**: Due to age-related health vulnerabilities.
- **Low-income Communities**: Who may lack access to healthcare, adequate housing, and resources to cope with climate-related disasters.
- **Indigenous Peoples**: Whose livelihoods and cultural practices are closely tied to the environment.
- **People with Pre-existing Health Conditions**: Who may be more susceptible to climate-related health risks.

**Mitigation Measures**

1. **Reducing Greenhouse Gas Emissions**: Transitioning to renewable energy sources, improving energy efficiency, and implementing policies to limit carbon emissions from industries, transportation, and agriculture.

2. **Adaptation Strategies**: Developing and implementing measures to adapt to climate change impacts, such as improving infrastructure resilience, enhancing early warning systems, and promoting sustainable land and water managem

1. JARAMOGI OGINGA ODINGA
UNIVERSITY OF SCIENCE AND TECHNOLOGY
Centre for E-learning
JOOUST is ISO 9001 : 2015 Certified
HCB 1415 –Climate Change and Health
Lecture 7: Climate Change burden of disease
Semester: August –December 2022
Lecturer: Wycliffe Omondi

2. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Climate change and health
Climatechangeplaysaroleinalteringhumanhealth,particularlyinthe
emergenceandspreadofdiseases.
Therefore,itisimportanttounderstandtherelationshipbetweenclimateand
healthasasignificantburdenofdiseasesonnationaleconomiesandpublic
health.
Thiscallfortheneedtoassess,anticipate,andmonitorhumanhealth
vulnerabilitytoclimatechange,inordertoplanfor,orimplementactionto
avoidtheseeventualities.

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Environment health indicators
Environmentalhealthindicators(EHIs)provideatooltoassess,monitor,and
quantifyhumanhealthvulnerabilitytoenvironmentalimpacts.
AnEHIisdefinedas:“Anexpressionofthelinkbetweenenvironmentandhealth
targetedatanissueofspecificpolicyormanagementconcernandpresentedina
form,whichfacilitatesinterpretationforeffectivedecisionmaking”
EHIsarevaluabletooltoassess,quantify,andmonitorhumanhealthvulnerability,
designandtargetinterventions,andmeasuretheeffectivenessofenvironmental
adaptationandmitigationactivities.

4. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Environment health indicators…cont.
EHIsenabletheconversionofdatatoinformationbysummarizingthecomplex
relationshipsbetweentheenvironmentandhealth,andpresentingtheminaformthat
ismoreeasilyinterpretedbytheend-users,forexample,policymakers.
FrameworksareusedasaguidefordevelopingEHIstomeasureandmonitorthe
impactsofenvironmentonhumanhealthandinformthedevelopmentof
interventions.
AprimarycharacteristicofEHIsisthattheyprovideinformationabouta
scientificallybasedlinkagebetweentheenvironmentandhealth.

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Characteristic of a good EHI
ThedevelopmentofgoodEHIsischallengingbecausetheymust
satisfymultiplecriteriainordertobeeffective.
ThefollowingareacharacteristicsofagoodEHI
shouldbescientificallyvalidorcredible,
haveclearrelevanceandutility,
andbepractical

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Climate Change EHIs
Climatechangeenvironmentalhealthindicators(CCEHIs)aremore
definedEHIsthatarespecificallyaimedatmonitoringtheeffectsof
climatechangeonhealth.
Theycanbedefinedas“anexpressionofthelinkbetweenclimate
changeandhealth,targetedtoaspecificpolicyormanagementconcern
andpresentedinaform,whichfacilitatesinterpretationforeffective
decision-making”.

7. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Climate Change EHIs…cont.
CCEHIsaimtoenabletheidentificationandanalysisofthegeneral
consequencesofclimatevariationandchangeonhumanhealth.
Theyenabletheinclusionofthemyriadofpossibleimpactsonnaturaland
constructedsystemsthatcouldhavesecondaryorincidentalhealtheffects.
Theyalsoprovidebaselineinformationforassessingandmonitoringtemporal
andspatialvariabilityofrisks,enablingprojectionscenariosofhowthe
currentsituationmayevolve.

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Climate change EHIs…cont.
ACCEHIisbasedonaknownrelationshipbetweenclimate,an
environmentalexposure,andhealth.
Theyhaveanimportanttemporalcomponentastheyareusedto
detectchangeovertime,therefore,datacollectedoverlongperiods
oftimearerequired.
CCEHIsshouldbebothscientificallyvalidandpoliticallyrelevant

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Climate change and health frameworks
ForEHIsdevelopmentandpresentation,itisimportanttodoasystematic
structuredframeworktoenableconsistentmonitoringandinterpretation.
Giventhecomplexityofenvironmentalhealthissues,itisbeneficialtousea
frameworktodevelopandstructureEHIs.
Aframeworkprovidesasystematicapproachthataidsinterpretationofthese
complexenvironmentalhealthissuesbydemonstratinglinksorrelationships
betweentheenvironmentandhumanhealth.

10. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Climate change and health frameworks
Themainroleofaframeworkistoorganizetheconcepts,ideas,and
notionsofasubjectmeaningfully.
Arobustframeworkshouldhave:
Conceptualclarityandscope–coverskeyconceptandlinks
Flexibility–considersissuesatanystageorcomponent
Balance–accommodatesissuesequally
Usability–usedinviablemethodologies

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Climate change and health frameworks
Severaldifferentframeworkshavebeendevelopedandusedinstudyingthe
environmentalcausesofdisease.
Variousframeworkshavebeendevelopedintheareasofenvironment,health,
environmentalhealth,andindicators.
However,itisdifficultforanyframeworktofullyrepresentthecomplexinteractions
involvedinassessingtheimpactsofclimatechangeonhumanhealth.
Frameworksshouldbeseenastoolsthatcanbemodifiedaccordingtorequirements.

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Frameworks –Examples
1.Pressure-State-ResponseFramework
2.DrivingForce-State-ResponseFramework
3.DrivingForce-Pressure-State-Impact-Response
Framework
4.BurdenofDiseaseFramework
5.MillenniumEcosystemAssessment-Ecosystems
Services
6.CausalWebs
6.DrivingForce-Pressure-State-Exposure-Effect-
ActionFramework
7.MultipleExposures-MultipleEffectsFramework
8.EnvironmentalPublicHealthIndicator
Framework
9.HealthImpactAssessment
10.IntegratedEnvironmentalHealthImpact
Assessment

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DPSEEA Framework
Thedrivingforces–pressures–state–exposure–effect–action(DPSEEA)frameworkis
widelyused.
ItisconsideredtobethebestsuitedfordevelopingEHIstoassessandmonitor
humanhealthvulnerability,toaidinthedesignandtargetingofinterventions,and
measuretheeffectivenessofclimatechangeadaptationandmitigationactivities.
Italsohasthepotentialtotriangulateandidentifyemergingecologicalproblems.It
incorporatethemonitoringandintegrationofhuman,animal,andenvironmental
(includingplants)healthdata.

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DPSEEA Framework…cont.
Drivingforcesarethefactors(anthropogenic)thatmotivateandpushthe
environmentalprocessesinvolved.
Pressures(ontheenvironment)arenormallyexpressedthroughhumanoccupationor
exploitationoftheenvironment.
State(oftheenvironment)isthecurrentstatusoftheenvironment.
Exposure(human-environmentalinteracts)referstotheintersectionbetweenpeople
andthehazardinherentintheenvironment.
Effect(inhumans)–healtheffectsfromexposuretotheenvironmentalhazard.

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DPSEEA Framework…cont.
Action–policiesorinterventionsaimedatreducingoravoidinghealtheffects,theycanbe
aimedatanypointintheframework.
DPSEEAframeworkwasdesignedtosupportdecisionmakingonactionstoreducethe
burdenofdiseasebydescribingenvironmentalhealthproblemsfromtheirrootcausesthrough
totheirhealtheffects,andbyidentifyingareasforintervention.
ThefigureillustrateshowtheDPSEEAframeworkcanbeadaptedtoaddressthepotential
healtheffectsofglobalclimatechange.
Theframeworkcanbeusedtoidentifytheenvironmentalcausesofdiseaseinacausalweb.

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DPSEEA Framework…cont.
DPSEEA
framework
for describing linkages between
health and climate change
Causal
web for the associations between climate
and one vector
-
borne disease (malaria)

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Climate change burden of disease
Projectionsareusedtoprojectmortalityormorbidityintothefuture.
Projectingthepotentialhealthimpactofclimatechangerequiresdifferentmethods
becausetheobjectiveistoestimatetheimpactofdifferenttypesof(future)climate
exposureondifferent(future)diseasepatternsatspecifictimesinthefuture.
Atthesimplestlevel,theburdenofdiseaseattributabletoclimatechangecanbe
calculatedas:
Attributableburden=(estimatedburdenofdiseaseunderclimatechangescenario)–
(estimatedburdenofdiseaseunderabaselineclimate,suchasthatin1961–1990).

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Using scenarios to estimate future effects
Scenariosprovideanimportanttoolforestimatingthepotential
impactofclimatechangeonspecifichealthoutcomes.
Scenariosdonotpredictfutureworldsorfutureclimates.
Therearemanywaysofapplyingscenarios,whichhavebeen
variouslydefinedas:

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Using scenarios to estimate future effects
1.Plausibleandoftensimplifieddescriptionsofhowthefuturemaydevelop
basedonacoherentandinternallyconsistentsetofassumptionsabout
drivingforcesandkeyrelationships;
2.Hypotheticalsequencesofeventsconstructedforthepurposeoffocusing
attentiononcausalprocessesanddecisionpoints;and
3.Archetypaldescriptionsofalternativeimagesofthefuture,createdfrom
mentalmapsormodelsthatreflectdifferentperspectivesonpast,present
andfuturedevelopments.

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Using scenarios to estimate future effects
Climatescenarios–Useofclimatemodels(e.g.IPCC),climatescenariosare
notprojectionsorpredictions.
Populationscenarios–Populationprojectionsareavailablefromavarietyof
nationalandinternationalsources.
Socioeconomicscenarios–Adaptationtoclimatechangewilltakeplaceina
dynamicsocial,economic,technological,biophysicalandpoliticalcontext
thatvariesovertimeandlocationandacrosscommunities.

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Heat and heat waves effects
Thereisevidencethatclimatechangeaffectstemperature-relatedmortalityand
morbidity.
Physiologicalandbiometeorologicalstudieshaveshownthathighandlow
temperaturesaffecthealthandwell-being.
Hightemperaturescausewelldescribedclinicalsyndromessuchasheatstroke,heat
exhaustion,heatsyncopeandheatcramps.
Severalmethodshavebeenusedtoestimatetheeffectofthethermalenvironmenton
mortalityandmorbidity.

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Heat and heat waves effects…cont.
Thepreferredepidemiologicalmethodforestimatingtheimpactof
temperatureonmortalityistime–seriesstudiesofdailymortality.
Themethodsareconsideredsufficientlyrigoroustoassessshort-term(day-to-
dayorweek-to-week)associationsbetweentheenvironmentalexposureand
mortalityifadjustmentismadeforlonger-termpatternsinthedataseries.
Therelationshipbetweentemperatureandmortalitycanbederivedusinga
regressionmodelthatquantifiestheextenttowhichday-to-dayvariabilityin
deathsisexplainedbyvariationintemperature.

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Heat and heat waves effects…cont.
Therelationshipbetweentemperatureand
mortalityisoftennonlinearacrossthewhole
temperaturerange.
Moststudiesreportalinearrelationshipabove
andbelowaminimummortalitytemperature
(orrangeoftemperatures).
Forfuturehealthimpacts,modellingstudies
haveestimatedtheimpactofclimatescenarios
onarangeofbiometeorologicalindices,such
astheheatindexorperceivedtemperature.
Relationship between temperature and mortality in Cape Town, London, New Delhi and Budapest

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Air pollution
Thereisevidencethatclimatechangecouldaffectairqualityandtherebyhealth.
Weatherconditionsinfluenceairqualityviathetransportand/orformationof
pollutants(orpollutantprecursors).
Exposuretoairpollutantscanhavemanyserioushealtheffects,especiallyfollowing
severepollutionepisodes.
Long-termexposuretoelevatedlevelsofairpollutionmayhavegreaterhealth
effectsthanacuteexposure.

25. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Air pollution…cont.
Severalmethodshavebeenusedtoestimatethehealtheffectsofexposureto
airpollutants.
Cohortstudiesgivesthemostcompleteestimatesofbothattributable
numbersofdeathsandaveragereductionsinlifespanassociatedwith
exposuretoairpollution
Riskassessmentcanbeused,however,thereshouldacarefullyevaluation
whetherapplyingtheexposure–responserelationshipfromonepopulationto
anotherisappropriate.

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Air pollution…cont.
Time–seriesmethodscanbeusedtoestimatetheimpactofairbornedust(windblown
soil)onhealthoutcomes.
Methodsforestimatingfuturehealthimpactincludes,modellingcurrentandfuture
pollutantconcentrations,thoughthisverycomplex.
Futureemissionsareestimatedusinglinkedmodelsofenergyuseandeconomic
activity.
Atmosphericchemistrymodelsneedtobelinkedtoemissionsprojectionstoestimate
futureairqualityattheappropriategeographicalandtemporalresolution.

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Extreme events –Floods, windstorms
Thereisevidencethatclimatechangeaffectsthehealthimpactofweatherdisasters
(floods,windstormsanddroughts).
Extremeweathereventscausedeathandinjurydirectly,effectsofdroughtare
primarilyassociatedwithfoodsecurityandincreasingwaterbornedisease.
Increasesinrespiratoryanddiarrhoealdiseasesbecauseofcrowdingofsurvivors,
oftenwithlimitedshelterandaccesstopotablewater.
Bereavement,propertylossandsocialdisruptionmayincreasetheriskofdepression
andmentalhealthproblems

28. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Extreme events –Floods, windstorms
Severalmethodshavebeenusedtoestimatethehealtheffectsofdisasters.
Informationontheimpactofdisastersmaybeavailablefromthenational
meteorologicalagencyorthenationalagencyfordisastersoremergencyservices.
Thetotalhealthimpactofadisasterisdifficulttoquantify,becauseinjuriesand
secondaryeffectsarepoorlyreportedandcommunicated
Currentvulnerabilitytoweatherdisastersneedstobedescribedintermsoftotaland
age-specificmortalityandmorbidity.

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Extreme events –Floods, windstorms
Floods-Invulnerableregions,theconcentrationofriskswithbothfood
andwaterinsecuritycanmaketheimpactofevenminorweather
extremes(floodsanddroughts)severeforthehouseholdsaffected.
Epidemiologicalstudiesoffloodeventsareundertakeninrelationtothe
healthoutcomestocompareincidenceinthepre-andpost-flooding
situations(injuries,infectiousdiseases,mentaldisordersetc.).
Routinesurveillancemayprovidedataonepisodesofinfectiousdisease
bothbeforeandafteraflood.

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Extreme events –Floods, windstorms
Droughts-Couldsubstantiallyaffectwaterresourcesandsanitationinsituationswherewater
supplyiseffectivelyreduced.
Epidemiologicalassessmentsareusedtoquantifytherisk(waterquality,increaseinpathogensand
diseases,malnutritionetc.)
Estimatingtheimpactofclimatechangeonclimateextremesisverydifficultasclimate
scenariosdonottypicallyincorporateinformationonextremeevents.
However,informationmaybeavailablefromothersources(riskofcoastalandriverine
flooding,changeinfrequencyofwindstorms,frequencyandintensityofElNiñoevents,
droughtrisks).

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Vector-borne diseases
Thereisevidencethatclimatechangeaffectstheburdenofvector-bornedisease.
Vectororganismsthatdonotregulatetheirinternaltemperaturesaresensitiveto
externaltemperatureandhumidity.
Climatechangemayalterthedistributionofvectorspecies(un/favourablebreeding).
Temperaturecanalsoinfluencethereproductionandmaturationrateoftheinfective
agentwithinthevectororganismandthesurvivalrateofthevectororganism,
therebyfurtherinfluencingdiseasetransmission.

32. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Vector-borne diseases
Climateeffectsonvector-bornediseaseshouldbeanalyzedasawhole,combining
climatedatawithconcurrentmeasurementsofthevectorialcapacityandinfection
rateofvectors,abundanceandinfectionrateofreservoirhosts(ifany)andthe
infectionrateandeventualhealtheffectsonhuman.
Therelationshipsbetweenclimateanddiseasedistributionandtransmissionhave
beeninvestigatedformanyvector-bornediseases,includingthedevelopmentof
predictivemodels.
Predictivemodelscanbebroadlyclassifiedasbiologicalorstatistical.

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Vector-borne diseases
Biologicalmodels–Arebasedonaggregatingtheeffectofclimateon
theindividualcomponentsofthediseasetransmissioncycle.
Statisticalmodels–Arederivedfromdirectcorrelationsbetween
geographicalortemporalvariationsinclimateandassociatedvariation
indiseaseincidenceordistribution,eitherinthepresentorrecentpast.
Theaboveinvolves,mappingdiseaseintimeandspace,geographical
informationsystem,interannualclimatevariabilityetc.

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Vector-borne diseases
Mappingdiseaseintimeandspace–demonstratesclimateeffectsontheabundance
anddistributionsofvectorseithernoworintherecentpastconstituteindirect
evidencethattheyhavebeen,orcouldbe,affectedbyclimatechange.
Geographicalinformationsystem–linkstogethergeographicalinformationvector-
bornediseasesinthatareatoallowforstatisticalanalysis,trendsetc.
Interannualclimatevariability,ElNiñoandepidemicdisease–Severalstudies
haveidentifiedassociationsbetweendiseaseriskandElNiñoorLaNiñaevents.As
extremeweathercantriggerdiseaseoutbreaks.

35. http://www.ejooust.ac.keJOOUST is ISO 9001 : 2015 Certified
Vector-borne diseases…cont.
Therearemethodsforestimatingfuturehealthimpactifthediseaseisalreadypresent.
Modellingoftheeffectsofclimatechangeonvector-bornediseaseshasbeendone(e.g.
malaria).
Biologicalmodelsofvector-bornediseasetransmission–Biologicalmodelsofmalariaare
basedontherelationshipsbetweentemperatureandtheextrinsicincubationperiodofthe
parasite,andthereforetheprobabilityofcompletingthetransmissioncycle.
Statisticalmodels–Modelshavebeendevelopedthatusestatisticalrelationshipstodefinethe
distributionallimitsofdisease.

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Vector-borne diseases…cont.
Vector
-
borne diseases that are
sensitive to climate change
Map of the
transmission
season length for
P. falciparum
malaria in Africa
under current
climate
Estimated
R
o
for
selected European countries.

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Vector-borne diseases…cont.
Therearealsomethodsforestimatingfuturehealthimpactifthediseaseisnotcurrently
present.
Climatechangemayaffecttheriskoftheintroductionofadiseaseintoanareawhereithas
beenpresentpreviously(re-emergence)orwhereithasneverbeenpresent(emergence).
Forexample,malariaiscurrentlyconfinedtotropicalareas,butatthepeakofitsdistribution
itwaspresentinmanymiddle-latitudecountries
Thebasicreproductionnumber(R
0)canbeusedasanindicatorofthevulnerabilityofa
countryorregiontothereintroductionofmalaria.

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Vector-borne diseases…cont.
R
0canbecalculatedfrominformationonindigenouscases(thecasesacquired
withinthecountryandnotimported)andthecapacityofthemostimportant
vectors.
Forexample,foraEuropeancountry,R
0canbemeasuredastheratioof
indigenoustoimportedcases,makingthereasonableassumptionthatthe
wholepopulationissusceptibletomalaria.
Suchcalculationsrelyontheaccuratereportingofcasesofindigenous
transmission;theaccuracyofreportsvariesbetweencountries.

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Water quality –Water-borne disease
Climatechangecouldgreatlyinfluencewaterresourcesandsanitationin
situationswherewatersupplyiseffectivelyreduced.
Droughteventscanleadtoanincreasedconcentrationofpathogenic
organismsinrawwatersupplies.
Inaddition,waterscarcitymaynecessitateusingsourcesoffreshwaterof
poorerquality,suchasrivers,whichareoftencontaminated.Increasesin
rainfallmaycausefloodingandoverwhelmseweragesystems.
Allthesefactorscouldresultinanincreasedincidenceofdisease

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Water quality –Water-borne disease
Methodsforestimatingthehealthimpactofweatherincludes
Time–seriesmethodscanbeusedtoquantifyanassociationbetweenvariation
(daily,weeklyormonthly)indiarrhoeaoutcomesandenvironmental
temperature.
Theseasonalcycleandotherlong-termpatternsshouldberemovedfromthe
dataseriestoaddressnon-temperature-relatedseasonalfactors.
Otherconfoundersshouldbetakenintoaccountinthemodellingprocess.

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Water quality –Water-borne disease
Methodsforestimatingfuturehealthimpactincludes:
Modellingtheeffectsofchangesintemperature–Linksincreasingtemperatureto
diseaseincidenceandchangingrainfallpatterns.Time-seriesanalysisisusedto
correlatemeasurementsoftemperatureandrelativehumiditywithdailyhospital
admissionsorincidenceofdisease.Poissonregressioncanalsobeused.
Modellingtheeffectsofchangesinrainfall–Linksthepotentialimpactofchanges
inrainfallonwaterbornedisease.Itaddressedtheroleofrainfallineithertriggering
individualoutbreaksorintheoverallburdenofwaterbornedisease.

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Food security
Foodsecurityremainsoneofthemainpoliticalconcernsofclimatechange.
Highseasonalandyear-to-yearvariabilityinfoodsupplies,oftentheresultof
unreliablerainfallandinsufficientwaterforcropandlivestockproduction,isamajor
contributortochronicundernutritionandfoodinsecurity.
Thereisevidencethatclimatechangewillaffectthefoodsupplyandtherebyhealth?
Thefollowinggroupsmaybemostatrisk:ruralsmallholderproducers,pastoralists,
ruralwagelabourers,urbanpoorpeople,refugeesanddisplacedpeopleetc..

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Food security…cont.
Climatechangecouldaffectfoodproductioninseveralways:
Geographicalshiftsandyieldchangesinagriculture;
Reductioninthequantityofwateravailableforirrigation;
Lossoflandthroughrisingsealevelandtheassociatedsalinization;and
Effectsonfisheriesproductivitythroughrisingsealevelandchangesin
watertemperatures,currents,freshwaterflowsandnutrientcirculation.

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Food security…cont.
Methodsforestimatingfuturehealthimpacthavebeenused.
Nationalassessmentshaveusedmodelsthatsimulatetheeffectsofclimatescenarios(and
otherscenarios)oncropyieldsandfood-relatedoutcomes.
Predictingtheimpactofclimatechangeoncropandlivestockyieldsiscomplex.Agricultural
productionissensitivetothedirecteffectsofclimate,especiallyextremeweatherevents.
Itisalsosensitivetotheindirecteffectsofclimateonsoilquality,theincidenceofplant
diseasesandweedandinsect(includingpest)populations.Inparticular,irrigatedagriculture
wouldbeaffectedbychangesinwaterresources.

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Food security…cont.
Fewstudieshavemappedclimate,environmentandnutritionaloutcomesatthenationalorlocallevel.
Attheglobalandregionalscale,integratedassessmentoftheimpactofclimatechangeofpopulations
atriskofhungerhasbeenattempted.
Nationalandregionalassessmentsoftheimpactofclimatechangeonagriculturalproductivitymaybe
availableatthenationalorsubnationallevel,asagricultureisanimportanteconomicsectorinmany
countries.
Studiesfocusonmodelsimulationsforchangesincropyieldandagriculturalriskbutprovidelimited
informationonfuturevulnerabilitytoundernutrition.
Theapplicationofascenario-drivenapproachrequiresasophisticatedapproachtothedevelopmentof
non-climatescenariosapproaches.

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Vulnerable population
Manyeffectsarenotdiseasespecificbutaddressmorebroadquestionsforhuman
health(directhealtheffects,conflicts,migrations,productionactivitiesandfood
insecurityetc.)
TheIPCC(1990)notedthat“thegreatesteffectofclimatechangemaybeonhuman
migrationasmillionsofpeoplewillbedisplacedduetoshorelineerosion,coastal
floodingandagriculturaldisruption”.
Refugeesrepresentaveryvulnerablepopulationwithsignificanthealthproblems.
Large-scalemigrationislikelyinresponsetoflooding,droughtandothernatural
disastersassociatedwithclimatechange.

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Healthimpactsofclimatechange–Policyresponsetoclimate
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